Quick action is often essential when a high risk cardiac patient experiences a warning or life threatening arrhythmia. At the present time hospitalization is often required in order to continuously monitor a patient's electrocardiogram (ECG) and quickly detect any warning or life threatening arrhythmias. The cost of hospitalization is very high and thus it is highly desirable to monitor a patient's condition on an outpatient basis rather than having the patient hospitalized.
A wide variety of apparatus has been developed to monitor a patient's ECG outside of a hospital environment. However, the presently available out-patient monitoring apparatus has a variety of deficiencies. Some out-patient monitoring apparatus, such as holter devices, merely record the patient's ECG for examination at a later time. Some present day out-patient monitoring apparatus, such as event monitors) require the patient to take action when an arrhythmia occurs in order to record an ECG which is later transmitted to a clinician. Still other present day out-patient monitoring apparatus has a limited range, thus the patient must stay close to a base station.
While monitoring equipment has been described in the literature which is supposed to allow patients to be discharged from hospitals sooner than they would have been discharged without such equipment, many cardiac patients are still hospitalized for relatively long periods of time merely for the purpose of monitoring their condition and to insure that any arrhythmias are quickly detected and appropriate action taken.
The present invention is directed to an improved out-patient monitoring device which detects arrhythmias or other ECG morphology changes along with other physiological indications, and immediately notifies a central monitoring station without any action on the part of the patient. A clinician at the central station can be put into voice contact with the patient. Monitoring proceeds while additional data is being transmitted to the clinician. The present invention can also be applied to inpatient monitoring systems to improve monitoring efficiency.
With the present invention the clinician at the central station has both voice contact with the patient and access to the patient's current ECG and photoplethysmograph. The clinician can activate one or more interventional therapeutic devices attached to the patient such as an external defibrillator, a pacer or a drug infusion device. Furthermore the clinician can change various parameters, settings, or programs in the patient monitoring device on a real time basis.